Neighbors, Numbers

John McCain walks onto the Senate floor Tom Williams CQ Roll Call Getty.jpg
Photo: Tom Williams / CQ Roll Call / Getty

My neighbor introduced himself to me a few weeks ago.

He told me that he frequents McAlister’s Deli at North Hills, and that he likes to read crime novels. His favorite author is Patricia Cornwell.

(I also know from living in the apartment below him that he watches a lot of Law & Order. The “bong-bong” carries through the floor.)

He has amblyopia, and there’s a slight hesitation before he speaks. He volunteered a lot of this information without my asking.

At one point, he had a job working with computers, but he no longer works. He said he stopped after he was diagnosed with multiple sclerosis.

A 2013 study in the Journal of Medical Economics estimated that annual costs for MS treatments range from $8,528 to $54,244. Prescription drug treatment makes up the majority of those costs. It’s worth noting that this study is based on data measured between 1998 and 2008, so newer, more costly treatments aren’t accounted for.

I don’t know my neighbor, even after having met him. We haven’t crossed paths since that Saturday afternoon. But I’m under the impression that people renting single-bedroom apartments don’t pay for expensive medical treatments by themselves.


Today, the Senate voted on a motion to proceed that will open the floor for debate on their health care bill. The motion passed 51-50 with Vice President Mike Pence casting a tie breaking vote.

Exactly which bill the Senate plans on debating is unknown, but there have been three such bills discussed in recent weeks. One version of the bill is the Better Care Reconciliation Act (BCRA), the bill written in secret and met with enough opposition to temporarily stall proceedings several times throughout this month.

Another version of the bill is the Obamacare Repeal Reconciliation Act (ORRA). This is the “repeal, then replace” bill that would give the Senate two years to pass replacement legislation while the Affordable Care Act (ACA) sunsets. It was immediately opposed by three Republican senators within 24 hours of it being proposed.

The last version is a “skinny repeal” that would get rid of the most unpopular parts of the ACA, namely the individual mandate. The purpose of this skinny repeal is to come up with anything capable of grabbing 51 votes in the Senate, allowing for corrections to be made in conference between both houses of Congress. This is the same argument used to convince wavering House Republicans who were told the Senate would fix the American Health Care Act (AHCA) that the House passed in May.

Throughout the debate this summer, the Congressional Budget Office (CBO) has chimed in to forecast the fallout from each of these bills. The estimates have had an effect on the debate thanks to numbers like these:

CBO on the AHCA:

“…in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law. Under the legislation, a few million of those people would use tax credits to purchase policies that would not cover major medical risks.”

CBO on the BCRA:

“…in 2018, 15 million more people would be uninsured under this legislation than under current law. The increase in the number of uninsured people relative to the number under current law would reach 19 million in 2020 and 22 million in 2026. In 2026, an estimated 82 percent of all U.S. residents under age 65 would be insured, compared with 90 percent under current law.”

CBO on the ORRA:

“The number of people who are uninsured would increase by 17 million in 2018, compared with the number under current law. That number would increase to 27 million in 2020, after the elimination of the ACA’s expansion of eligibility for Medicaid and the elimination of subsidies for insurance purchased through the marketplaces established by the ACA, and then to 32 million in 2026.”

As for the skinny repeal that eliminates the individual mandate, the CBO says doing so would increase estimates of uninsured Americans from 28 million to 43 million by 2026. That proposal alone would account for 15 million fewer Americans having health insurance.

At no point has the CBO score been enough to kill the bill wholesale. These estimates have influenced the debate, but only as an impediment. The Republicans push back against them. The President and his surrogates downplay the CBO’s clout. They say it’s fake news.

While we’re talking about significant digits, consider that the 50 Senators who voted against today’s motion to proceed represent 36 million more citizens than the 50 Senators who voted for it. Also consider that every American pays for congressional health care plans with their taxes.

(I want to shoehorn this in here, too: medical crowdfunding is booming right now as people turn to sites like GoFundMe to raise money for their medical expenses. A study from November of last year showed that almost half of the money raised on GoFundMe in a given period went to medical campaigns.

But of those campaigns, only 1 in 10 reached their goal. The only ones this trend is good for are the crowdfunding sites.)

The last numbers I want to share are the phone numbers of our Senators in North Carolina.

Richard Burr
(202) 224-3154 (D.C.)

(800) 685-8916 (Winston-Salem)

Thom Tillis

(202) 224-6342 (D.C.)

(919) 856-4630 (Raleigh)

Senators Burr and Tillis both released statements today applauding the passage of the motion to proceed, saying that this will open up an “unlimited amendment process” for Senators on both sides of the aisle to have their say in the debate.

As far as actual procedure goes, the Senate is now required to have 20 hours of debate, after which they will vote on amendments and substitutes (alternative bills like the ORRA and the skinny repeal).

Again, it’s not yet clear which bill the Senate is actually planning to amend yet, but each of the three options (that we know of) would leave tens of millions of people without health insurance.

And that’s what it comes down to.

Burr and Tillis will vote yes on whatever the final version of the bill ends up being. They do not veer off course. They do not make the list of Senators that is frantically circulated whenever something momentous is about to happen. They do not feel endangered by the outcome of this vote or any other vote like it.

They see the numbers. They see the estimates. But they do not see the people who will endure hardship or worse.

Everyone can see when it’s someone they love, or someone they know. You know a grandparent who has been in the hospital recently. You know a friend’s mom who needed a transplant. You know a child born with some sort of condition or disability.

But not everyone sees beyond their circles. You might not see a family who still can’t afford health insurance because their state didn’t choose to expand the Medicaid coverage offered by the ACA. You might not see the people who resort to crowdfunding for lifesaving procedures. You might not see your neighbor living above you with multiple sclerosis.

But you should.

Everytime I see those numbers, I think of my neighbor and the millions of people like him. And when I call and write to our representatives, I will ask that they see them, too.